Establishing a quality control program: ensuring safety from contamination for recycled metered-dose inhalers
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Published on: March 17, 2023
Jenny Liou1, Kurt Clyne1, Donnet Knapp2
1Pharmacist, Saint Elizabeth Regional Medical Center , Lincoln, Nebraska .
Background:
Recycling metered-dose inhalers (MDIs) is an effective method to conserve medications resulting in significant cost savings to the hospital. A noted limitation in some reports is the potential for cross-contamination.
Objective:
To implement a quality control program to monitor and validate the safety of recycled MDIs for institutional reuse.
Methods:
A quality control program was conducted from December 2012 to May 2013. At a 257-bed acute care facility, MDIs are administered to a single patient using a patient-specific valved holding chamber and then returned to the pharmacy for cleaning with 70% isopropyl alcohol prior to re-dispensing to a new patient. Ten percent of MDIs from 3 categories were categorized: prior to pharmacy cleaning, after pharmacy cleaning, and new/unused control group each month. The mouthpiece and canister spray tip from each MDI were tested. Any bacterial growth was documented. A secondary test was conducted to ensure that artificially contaminated MDIs could be cleaned with current cleaning procedures. Cost savings measures were also quantified.
Results:
There was no bacterial growth on the 17 recycled MDIs cultured prior to the cleaning process. Bacteria did not grow on any of the 33 recycled MDIs cleaned with 70% isopropyl alcohol. Likewise, in the control group of 33 new/unused control MDIs, there was no bacterial growth. No bacteria growth was found after cleaning each artificially contaminated MDI. Total drug cost savings during the study period was approximately $130,000.
Conclusions:
Establishing a strict quality control program is paramount to validating a safe and effective recycled MDI procedure.
Insights
Recycling metered-dose inhalers (MDIs) is safe and cost-effective when using a strict quality control program. This process prevents cross-contamination and saves hospitals significant medication costs.
Area of Science:
- Pharmaceutical Sciences
- Infection Control
- Healthcare Management
Background:
- Recycling metered-dose inhalers (MDIs) offers substantial cost savings by conserving medications.
- A key concern with MDI recycling is the potential for cross-contamination between patients.
Purpose of the Study:
- To establish and validate a quality control program for the safe reuse of recycled metered-dose inhalers (MDIs) in an institutional setting.
- To assess the efficacy of cleaning procedures in preventing microbial contamination.
Main Methods:
- A quality control program monitored recycled MDIs over six months at a 257-bed acute care facility.
- Metered-dose inhalers (MDIs) were cleaned with 70% isopropyl alcohol after single-patient use.
- Microbial testing was performed on MDIs before and after cleaning, alongside a new/unused control group.
Main Results:
- No bacterial growth was detected on recycled MDIs before or after cleaning with 70% isopropyl alcohol.
- The control group of new/unused metered-dose inhalers (MDIs) also showed no bacterial growth.
- Artificially contaminated MDIs were successfully decontaminated using the established cleaning protocol, with approximately $130,000 in drug cost savings.
Conclusions:
- A rigorous quality control program is essential for ensuring the safety and effectiveness of recycled metered-dose inhaler (MDI) procedures.
- Implementing such programs can lead to significant cost savings without compromising patient safety.
